桂枝附子汤加减联合动痛点针刀松解术治疗冻结肩急性期的效果研究

Effect of Guizhi Fuzi Decoction(桂枝附子汤)Combined with Needle Knife Release of Moving Pain Point in Treatment of Frozen Shoulder in Acute Period

目的观察桂枝附子汤加减联合动痛点针刀松解术治疗冻结肩急性期的效果。方法选取医院于2018年1月—2020年8月收治的急性期冻结肩患者126例,参考治疗方案分为对照组和观察组,每组63例。对照组给予动痛点针刀松解术治疗,观察组给予动痛点针刀松解术联合桂枝附子汤加减治疗,共治疗4周。比较治疗4周后两组整体疗效,评价两组治疗前、治疗4周后肩功能评分、美国肩与肘协会评分系统(ASES)评分、视觉模拟(VAS)评分,比较治疗前、治疗4周后两组疼痛因子[前列腺素E2(PGE2)、缓激肽、5-羟色胺(5-HT)]水平。结果治疗4周后,两组的内旋、外旋、患侧反手摸背、患手摸耳评分及ASES评分上升,PGE2、缓激肽、5-HT及VAS评分下降,且观察组治疗4周后肩功能评分、ASES评分较对照组高,PGE2、缓激肽、5-HT及VAS评分较对照组低(P<0.05)。观察组治疗4周后,痊愈18例,显效32例,有效9例,对照组治疗4周后,痊愈12例,显效23例,有效17例,观察组整体疗效优于对照组,有统计学意义(P<0.05)。结论桂枝附子汤加减联合动痛点针刀松解术治疗冻结肩急性期可有效缓解疼痛,降低疼痛因子的表达,改善肩功能。

Objective To observe the effect of Guizhi Fuzi Decoction(桂枝附子汤)combined with needle knife release of moving pain point on frozen shoulder.Methods A total of 126 patients with acute frozen shoulder treated in the hospital from January 2018 to August 2020 were selected.According to the reference treatment plan,the patients were divided into control group and observation group,63 cases in each group.The control group was treated with acupuncture and needle knife release of moving pain point,and the observation group was treated with acupuncture and needle knife release of moving pain point combined with Guizhi Fuzi Decoction for 4 weeks.The overall efficacy of the two groups was compared after 4 weeks of treatment.The shoulder function score,the american shoulder and elbow association scoring system(ASES)score,scoring system(ASES)score and visual simulation(VAS)score were evaluated.The pain factors[prostaglandin E2(PGE2),bradykinin,serotonin(5-hydroxytryptamine)]were compared between the two groups before and after 4 weeks of treatment.Results After four weeks of treatment,the scores of internal rotation,external rotation,backhand touch of the affected side,ear touch of the affected hand and ASES of the two groups were increased,and the scores of PGE2,bradykinin,5-HT and VAS were decreased.The scores of shoulder function and ASES in the observation group were higher than those in the control group,and the scores of PGE2,bradykinin,5-HT and VAS were lower than those in the control group(P<0.05).After 4 weeks of treatment in the observation group,18 cases were cured,32 cases were effective and 9 cases were effective.After 4 weeks of treatment in the control group,12 cases were cured,23 cases were effective and 17 cases were effective.The overall curative effect of the observation group was better than that of the control group(P<0.05).Compared with that of the control group,the overall curative effect of the observation group was statistically significant(P<0.05).Conclusion Guizhi Fuzi Decoction combined with needle knife release of moving pain point can effectively relieve the pain,reduce the levels of pain factors and improve the shoulder function.